I interviewed Carrie during a break in the thesis presentations at CMU on May 12th, 2008.
Project Poster [PDF 1.1MB]
Direct Care: Enhancing Family Experience
- Welcome kit – Toy, blanket and camera
- In-room display – Digital information
- Mobile monitoring device – Webcam updates
- Parents’ corner – In-room whiteboard
- At-home website – Integrated information
- Farewell gift – Photos, cards
JEFF: Hi Carrie. Congratulations on your thesis presentation.
Let’s talk a little about your project. For people who aren’t familiar with it, you were working for the Children’s Hospital here in Pittsburgh. How did you decide to embrace this subject for your thesis?
CARRIE: In the service design class last year, we worked for UPMC and healthcare was something that really interested me. And then I was also interested in working with kids; that was one age group that I hadn’t worked with here. I’ve worked with elders, I’ve worked with parents, I’ve worked with freshmen and college students. I wanted to work with kids but unfortunately, because of IRB stuff [Institutional Review Board restrictions on working with children] I couldn’t. It’s still in that realm though. Everything is geared toward the kids.
JEFF: Did IRB have some specific objection to allowing you to work with kids? Or is it a blanket prohibition?
CARRIE: It was the overall thing. The IRB here [at CMU] was okay; but it was the IRB at University of Pittsburgh that I had to go through, and because they’re a very medical oriented… they didn’t approve of my research style, because it wasn’t “scientific” enough. So that took four months to learn that I didn’t need to go through IRB, that I could just go through quality assurance. Four months of wasted time…
Childrens Hospital didn’t used to be a part of UPMC, like they are now. So there’s a completely different board. It’s a different staff.
. . .
JEFF: Let’s talk a little about the process of working with an institution like that, in terms of how you approached the research and how you approached presenting your designs.
CARRIE: I ended up getting in contact with the director of nursing research and she became my mentor for the project. So, she’s the one who gave me access to different staff members; gave me access to this specific unit at UPMC. She was in charge of all the administrative stuff like getting my badge and my ID and stuff like that. Whenever I needed to contact people I talked to her and say that I needed to come in for some interviews and she’d hook me up. And she took care of all that for me.
Without her I wouldn’t have been able to do any of this. There’s a lockdown at the Children’s Hospital so you can’t even get in unless you have that badge, and you go through clearance. And once I go through her, I go to the charge nurse, up on the 7th floor where I worked. And I’d usually talk to her and ask if there were any families who were willing to talk that day. They were pretty familiar with all the families, so they directed me to the families who would be more willing to talk with me.
JEFF: How many different families did you work with?
CARRIE: I got to talk with six. I talked with them in about one to one-and-a-half hour interviews.
JEFF: In your presentation, you mentioned that there was quite a bit of overlap in the experiences for each of the families. I was surprised they they perceived things so similarly.
CARRIE: Literally, I was writing down the same thing every single time. And it wasn’t even all in one session; they were over the course of a month. And at one point I wondered if I should even keep talking to people because they kept saying the same things. But it was good because it confirmed things.
JEFF: Did you get the sense that the parents realized how common these problems were?
CARRIE: Oh, they knew. They’d say: “yeah, we get used to it.” They’d learn how things worked, but they were interested in how to improve it.
JEFF: In your presentation you also talked a little about participatory design. Can you talk a little about the process you used?
CARRIE: During exploratory research, one technique was to get them to design their ideal walkthrough. One where design accounts for the family. For instance, if someone else were going through the same situation, what would you provide for them? I had everything prepared; I had research cards, but because of the nature of Children’s Hospital, they’re busy with kids in their arms, and trying to attend to other things; it became more of a verbal interview, rather than having them do stuff. The idea of the interviews was great, but the setting didn’t work.
I made fake LCD screens and fake mobile devices and I had little labels and diagnoses to get them to make their own display. And I did that with one family, and it was successful, just in terms of the conversation it caused.
JEFF: Have you shown the final concepts to the families?
CARRIE: I talked to two families, but one of the moms got into this huge fight with the father of the child, so I just decided that I was going to leave… But I did talk to one family, but that would definitely be the next step. I didn’t actually get to start the project until January because of all the IRB delays. So everything sort of shifted, unfortunately.
JEFF: I’m interested in the ideas for the welcome kit. You had asked them what they would want, and to imagine what other people might want. What were the differences between what they wanted and what they thought other people might want?
CARRIE: I think when they removed themselves from their own situation and started thinking about “oh, yeah. This would be more helpful.” Talking about their own welcome kit was more just to get them to describe their problems currently, rather than focus on solutions.
I’m trying to come up with a system where all the patient status information could just be on their cellphones so you wouldn’t need to incur the cost in terms of insurance coverage [for the mobile devices] but right now it’s just a hospital device; it’s just a better interface.
JEFF: Can you tell me a little more about the whiteboard concept; the parents’ corner?
CARRIE: It was just a whiteboard, basically. A very analog solution. Parents kept on having to repeat information to hospital staff. Little things like “my baby responds better to this antibiotic.” Because of all the hospital staff switching they can get lost between them. I know that’s a communication problem on the part of the staff, but if the parents had this one corner where they could put down this information, they wouldn’t have to keep repeating, and it would be there while they were away at work.
Right now they’re just static whiteboards in each room, but you could have them mobile because they do move patients around. Or it could be integrated into the in-room [digital] display.
. . .
JEFF: After going through the Service Design course last year, are there certain aspects that influenced your thesis work?
CARRIE: I think most of what I learned dealt with looking at the experience as a start-to-end process. Looking at it as a customer journey.
Initially I was only looking at one unit; an intermediary care unit. And then I realized that wasn’t going to help solve things since it’s really a bigger problem. Looking back to my service design projects, I think some of the methods—I didn’t get to do any service blueprinting or stuff like that—but having done that on previous projects helped with how I thought about this experience; thinking about the various components. The front-stage and back-stage portions. I could focus on the front stage, knowing there was a backstage component to keep in mind.
JEFF: Have you shown these ideas to the UPMC staff to get their reaction?
CARRIE: I have not talked with them yet but I’m supposed to give a presentation once the documentation is completed. So hopefully that’ll be done over the next week.
They know all the problems that exist. It’s just about finding solutions.